Tips to Prevent Health Care Fraud

Reducing health care fraud is a joint effort between Blue Cross and Blue Shield of New Mexico (BCBSNM), its providers and its members.

Here are some ways you can help fight health care fraud:

  • Understand what your plan covers.
  • Review all Explanation of Benefits (EOB) statements. Make sure you had the medical exams, tests and treatments with the provider shown on the EOB. 
  • Understand what you are responsible to pay – know if your plan requires you to pay a deductible or copay.
  • Guard your BCBSNM member ID card, Social Security Number and other personal information. Call BCBSNM as soon as possible if your card or insurance information is lost or stolen.
  • Sign and date only one claim form per office visit.
  • Never lend your BCBSNM member ID card to someone else.
  • Don't give out your information if medical services or equipment are offered as "free." Be sure you understand what is "free." Also, find out what you and BCBSNM will be charged.
  • Before you have a medical test or treatment, ask your doctors exactly what they want you to have and why. If in doubt, get a second opinion from another doctor.
  • Monitor what prescription drugs you use. Make sure the medicines billed to BCBSNM are correct.
  • Be aware of phony sales pitches over the phone. Do not disclose your insurance or personal information.


 

Last Updated: May 20, 2021